Paper vs. Plastic

I hope to have time to post a good RVU calculation message this afternoon but, before I do, I wanted to share an excerpt from a PedTalk message this AM.  It comes from Dr. Lessin, with whom I often enjoy disagreeing particularly because we often actually share similar viewpoints.

I think the message below captures a growing vision of pediatrics-to-come, the dismay at the direction of the practice of medicine.  It’s like [censored]ens’ Christmas Story: this is the Ghost of Pediatrics Future.  Everyone whines about the “good ol’ days” in just about any context (“When I was in school…” or “In 1956, the New York Yankees…” or “They call that music?”), but I really think we are heading towards a nadir of satisfaction in this profession unless there are some significant changes.
Anyway, here it is.

Unfortunately, with the emphasis on consumer driven health care, we are  becoming even more focused on what people want as opposed to what they  need.  Hospitals design their systems to appeal to the customer.  That is  good, except when it impedes the doctor’s work flow and ability to provide  good care.  Patients come in demanding things that they have read about on the internet.  Sometimes, they are right.  Often they are wrong.  But since we are now a volume dependent business, we are terrified that they will go to someone who will give them what they want.  It is coming down to the fact that we might prescribe that useless antibiotic because the guy down  the street will do it and the patient will flame us on the net if we do not., and complain to the insurer about what an awful doctor we are.  It is a sad state of affairs.  I never thought that this profession would devolve  to the decision between paper or plastic.

Herschel Lessin MD

I don’t agree with him 100%, but boy that’s an excellent summary of the corner into which pediatricians have painted themselves.  Sure, it’s easy to pick on the position he takes here (I think of that awesome scene from Malice with Alec Baldwin), but that would miss the point.

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